1. Technical Field
The present disclosure relates generally to the field of endoscopic surgical devices. More specifically, the present disclosure relates to an endoscopic fastener applying device for repairing torn tissue such as torn meniscus tissue in the knee.
2. Background of Related Art
A technique has been developed using arthroscopic instruments which provides for meniscal repair through the use of a pair of surgical needles which are inserted through cannuli into the knee on opposite sides of the tear in the meniscus to be repaired. The needles are linked by a single suture which is pushed down through the cannuli and across the tear. An incision is made in the skin at the point where the needles exit the knee joint so that the leading end of each needle may be grasped and pulled through the joint. The ends of the sutures are then grasped after the needles are removed from the suture ends and the suture is then tied so that a horizontal suture is created in the meniscus. This procedure is repeated for placement of as many sutures as necessary to repair the meniscus tear. This process is time consuming, and the strength of the repair is dependent upon the tension created by the knot tied in the suture. There are significant inherent risks of injury to nerves and vascular structures when passing the needles and tying the suture over the nerves and vasculature of the underlying tissue.
An additional procedure and instrument is known from U.S. Pat. No. 5,002,562, in which a barbed clip and an instrument for applying the clip for repairing peripheral meniscal tears is disclosed. The instrument has a pair of opposed arcuate jaws which are shaped to hold a complementary-shaped curved surgical clip therebetween, such that the barbs of the clip are retained within notches in the jaws until the clip is inserted. The legs of the clip are typically joined by a flexible material, such as a suture. The jaws are biased in a normally open position, and as the jaws are pushed into the tissue, the jaws are scissored or closed together until they preferably overlap to move the legs of the clip together until they cross. The jaws are then reopened and backed out of the tissue, with the barbs of the clip retaining the clip in position in the tissue.